Individual provider Active NPI

Karan Kumar, MD

  • Geriatric Psychiatry Physician
  • Amityville, NY
National Provider Identifier
1063400042
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
142753-1 Issued in NY
Practice address
400 Sunrise Hwy
Amityville, NY 11701-2508
Phone
(631) 608-5620
Fax
(631) 396-0382
NPI assigned
Oct 12, 2005
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 142753-1 NY
Psychiatry Physician 2084P0800X 142753-1 NY
Geriatric Psychiatry Physician 2084P0805X 142753-1 NY Primary

Addresses

Primary practice location

400 Sunrise Hwy
Amityville, NY 11701-2508

Mailing address

400 Sunrise Hwy
Amityville, NY 11701-2508
Phone (631) 608-5620

Other identifiers 1

IdentifierTypeStateIssuer
00490244MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000350 NY Practitioner - Psychiatry 7618930199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1963
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

560 S Broadway
Suite 103
Hicksville, NY 11801-5013
Phone (516) 797-0282

Merit-based Incentive Payment System (MIPS)

Final score
22.91 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
76.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
142753-1NYMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Long Island Home CurrentSince Jan 1, 2012 Accepting new patients
The Long Island Home CurrentSince Jan 1, 2012 Accepting new patients

Locations

400 Sunrise Hwy
Amityville, NY 11701
Phone (631) 264-4000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1063400042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUNRISE HWY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012508",
            "telephone_number": "631-608-5620",
            "fax_number": "631-396-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUNRISE HWY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012508",
            "telephone_number": "631-608-5620",
            "fax_number": "631-396-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "KARAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NY",
            "license": "142753-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "142753-1",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "142753-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00490244",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.